Intravascular US: Applications in Interventional Radiology

Area of Science:

• Interventional Radiology
• Vascular Imaging
• Medical Ultrasound

Background:

• Intravascular ultrasound (IVUS) offers direct visualization of vascular pathology, surpassing limitations of traditional angiography.
• Current interventional radiology relies on indirect visualization, leading to potential inaccuracies in guiding endovascular interventions.
• The expansion of IVUS applications necessitates a structured overview of its capabilities and technical aspects.

Purpose of the Study:

• To provide a comprehensive overview of intravascular ultrasound (IVUS) applications in interventional radiology.
• To detail IVUS catheter types, technical specifications, and their use in various vascular conditions.
• To summarize evidence supporting IVUS benefits, including reduced procedural time, contrast dose, radiation, and morbidity.

Main Methods:

• Categorization of IVUS catheters into radial and side-firing types with technical specifications.
• Systematic review of IVUS applications in deep venous thrombosis, May-Thurner syndrome, nutcracker syndrome, TIPS, aortic interventions, PAD, and biopsies.
• Presentation of technical pearls and summarized evidence for IVUS efficacy.

Main Results:

• IVUS provides direct sonographic visualization of vascular structures and perivascular targets, unlike planar angiography.
• Evidence indicates IVUS can decrease procedural time, contrast agent volume, radiation exposure, and patient morbidity.
• Specific applications demonstrate IVUS's utility in complex vascular interventions.

Conclusions:

• Intravascular ultrasound (IVUS) is a valuable tool in interventional radiology, enhancing procedural guidance and patient outcomes.
• The technology offers significant advantages over conventional imaging for a wide range of vascular interventions.
• Emerging applications and future directions highlight the growing importance of IVUS in vascular interventions.